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92_SB1251 LRB9207851JScs 1 AN ACT concerning health benefits. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The State Employees Group Insurance Act of 5 1971 is amended by changing Section 6.5 as follows: 6 (5 ILCS 375/6.5) 7 Sec. 6.5. Health benefits for TRS benefit recipients and 8 TRS dependent beneficiaries. 9 (a) Purpose.
It isThe purpose of this amendatory Act 10 of 1995 is to transfer the administration of the program of 11 health benefits established for benefit recipients and their 12 dependent beneficiaries under Article 16 of the Illinois 13 Pension Code to the Department of Central Management 14 Services. 15 (b) Transition provisions. The Board of Trustees of the 16 Teachers' Retirement System shall continue to administer the 17 health benefit program established under Article 16 of the 18 Illinois Pension Code through December 31, 1995. Beginning 19 January 1, 1996, the Department of Central Management 20 Services shall be responsible for administering a program of 21 health benefits for TRS benefit recipients and TRS dependent 22 beneficiaries under this Section. The Department of Central 23 Management Services and the Teachers' Retirement System shall 24 cooperate in this endeavor and shall coordinate their 25 activities so as to ensure a smooth transition and 26 uninterrupted health benefit coverage. 27 (c) Eligibility. All persons who were enrolled in the 28 Article 16 program at the time of the transfer shall be 29 eligible to participate in the program established under this 30 Section without any interruption or delay in coverage or 31 limitation as to pre-existing medical conditions. -2- LRB9207851JScs 1 Eligibility to participate shall be determined by the 2 Teachers' Retirement System. Eligibility information shall 3 be communicated to the Department of Central Management 4 Services in a format acceptable to the Department. 5 (d) Coverage. The level of health benefits provided 6 under this Section shall be similar to the level of benefits 7 provided by the program previously established under Article 8 16 of the Illinois Pension Code. 9 Group life insurance benefits are not included in the 10 benefits to be provided to TRS benefit recipients and TRS 11 dependent beneficiaries under this Act. 12 The program of health benefits under this Section may 13 include any or all of the benefit limitations, including but 14 not limited to a reduction in benefits based on eligibility 15 for federal medicare benefits, that are provided under 16 subsection (a) of Section 6 of this Act for other health 17 benefit programs under this Act. 18 (e) Insurance rates and premiums. The Director shall 19 determine the insurance rates and premiums for TRS benefit 20 recipients and TRS dependent beneficiaries. For Fiscal Year 21 1996, the premium shall be equal to the premium actually 22 charged in Fiscal Year 1995. In subsequent years, the 23 premium shall never be lower than the premium charged in 24 Fiscal Year 1995. Rates and premiums may be based in part on 25 age and eligibility for federal medicare coverage. 26 The cost of health benefits under the program shall be 27 paid as follows: 28 (1) For a TRS benefit recipient selecting a managed 29 care program, up to 75% of the total insurance rate shall 30 be paid from the Teacher Health Insurance Security Fund. 31 (2) For a TRS benefit recipient selecting the major 32 medical coverage program, up to 50% of the total 33 insurance rate shall be paid from the Teacher Health 34 Insurance Security Fund if a managed care program is -3- LRB9207851JScs 1 accessible, as determined by the Teachers' Retirement 2 System. 3 (3) For a TRS benefit recipient selecting the major 4 medical coverage program, up to 75% of the total 5 insurance rate shall be paid from the Teacher Health 6 Insurance Security Fund if a managed care program is not 7 accessible, as determined by the Teachers' Retirement 8 System. 9 (4) The balance of the rate of insurance, including 10 the entire premium of any coverage for TRS dependent 11 beneficiaries that has been elected, shall be paid by 12 deductions authorized by the TRS benefit recipient to be 13 withheld from his or her monthly annuity or benefit 14 payment from the Teachers' Retirement System; except that 15 (i) if the balance of the cost of coverage exceeds the 16 amount of the monthly annuity or benefit payment, the 17 difference shall be paid directly to the Teachers' 18 Retirement System by the TRS benefit recipient, and (ii) 19 all or part of the balance of the cost of coverage may, 20 at the school board's option, be paid to the Teachers' 21 Retirement System by the school board of the school 22 district from which the TRS benefit recipient retired, in 23 accordance with Section 10-22.3b of the School Code. The 24 Teachers' Retirement System shall promptly deposit all 25 moneys withheld by or paid to it under this subdivision 26 (e)(4) into the Teacher Health Insurance Security Fund. 27 These moneys shall not be considered assets of the 28 Retirement System. 29 (f) Financing. Beginning July 1, 1995, all revenues 30 arising from the administration of the health benefit 31 programs established under Article 16 of the Illinois Pension 32 Code or this Section shall be deposited into the Teacher 33 Health Insurance Security Fund, which is hereby created as a 34 nonappropriated trust fund to be held outside the State -4- LRB9207851JScs 1 Treasury, with the State Treasurer as custodian. Any 2 interest earned on moneys in the Teacher Health Insurance 3 Security Fund shall be deposited into the Fund. 4 Moneys in the Teacher Health Insurance Security Fund 5 shall be used only to pay the costs of the health benefit 6 program established under this Section, including associated 7 administrative costs, and the costs associated with the 8 health benefit program established under Article 16 of the 9 Illinois Pension Code, as authorized in this Section. 10 Beginning July 1, 1995, the Department of Central Management 11 Services may make expenditures from the Teacher Health 12 Insurance Security Fund for those costs. 13 After other funds authorized for the payment of the costs 14 of the health benefit program established under Article 16 of 15 the Illinois Pension Code are exhausted and until January 1, 16 1996 (or such later date as may be agreed upon by the 17 Director of Central Management Services and the Secretary of 18 the Teachers' Retirement System), the Secretary of the 19 Teachers' Retirement System may make expenditures from the 20 Teacher Health Insurance Security Fund as necessary to pay up 21 to 75% of the cost of providing health coverage to eligible 22 benefit recipients (as defined in Sections 16-153.1 and 23 16-153.3 of the Illinois Pension Code) who are enrolled in 24 the Article 16 health benefit program and to facilitate the 25 transfer of administration of the health benefit program to 26 the Department of Central Management Services. 27 (g) Contract for benefits. The Director shall by 28 contract, self-insurance, or otherwise make available the 29 program of health benefits for TRS benefit recipients and 30 their TRS dependent beneficiaries that is provided for in 31 this Section. The contract or other arrangement for the 32 provision of these health benefits shall be on terms deemed 33 by the Director to be in the best interest of the State of 34 Illinois and the TRS benefit recipients based on, but not -5- LRB9207851JScs 1 limited to, such criteria as administrative cost, service 2 capabilities of the carrier or other contractor, and the 3 costs of the benefits. 4 (h) Continuation of program. It is the intention of the 5 General Assembly that the program of health benefits provided 6 under this Section be maintained on an ongoing, affordable 7 basis. The program of health benefits provided under this 8 Section may be amended by the State and is not intended to be 9 a pension or retirement benefit subject to protection under 10 Article XIII, Section 5 of the Illinois Constitution. 11 (Source: P.A. 89-21, eff. 6-21-95; 89-25, eff. 6-21-95.)
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